The purpose of this proposal is to summarize the resources at Magee Womens Hospital of the University of Pittsburgh Medical Center (UPMC) and to demonstrate how we can meaningfully contribute to the mission and objectives of the NICHD- sponsored Maternal-Fetal Medicine Units Network. Our Unit has been an active participant in the MFMU Network since its inception 24 years ago. During our tenure, which is the longest of all current or past MFMU sites, we have demonstrated our willingness to cooperate with other institutions and the NICHD in the development and implementation of clinical research protocols. We have been active participants in every aspect of Network activities. We have proposed protocols, have served on subcommittees of other protocols, have served on administrative subcommittees, have served as site visitors to evaluate other centers and have faithfully attended every one of the more than 94 Network meetings over the last 24 years. We have effectively recruited patients and have provided intellectual input in the development of new projects as well as the implementation of protocols from our center and from others. Our primary site includes 13 Maternal-Fetal Medicine specialists, 1 perinatal epidemiologist, 6 midwives, 5 generalists, 7 research nurses, and 3 research associates who have committed in some way to the Network, either in the recruitment of patients, implementation of the studies at our site, patient evaluation, biological fluid collection, obtaining consent or development of protocols. Nine research faculties in the Division are available to provide specialized expertise for Network projects. The obstetrical unit at the University of Pittsburgh is one of the largest private obstetrical services in the United States with nearly 10,000 deliveries annually. Approximately 40% of our patients are deemed to be high risk prior to labor. Approximately 2200 women delivering at Magee are indigent; 1800 are black or Hispanic and 6500 are white, most of who have third party insurance. The rates of smoking, obesity, drug abuse and hypertension at our center are among the highest in the Network. These characteristics among our patients assure that results of Network studies are widely applicable across an entire spectrum of subjects. In January 2010, 37 private OB/GYN physicians were acquired by the Department of OB/GYN dramatically increasing our access to research subjects. To further enhance our population base, in May 2010,we initiated a collaborative agreement with the only other level 3 Obstetrical service in the city , the West Penn Hospital with 3700 deliveries. This satellite is participating in other Magee research efforts including the MFMU (SCAN study) the Obstetrical-Fetal Pharmacology Research Units Network and the Nullipara Network. In this proposal we will: 1) describe our academic productivity and our contributions to the current Network, 2.) demonstrate the capabilities of our Unit 3). Provide evidence of our continuing commitment to the success of the Network of Maternal-Fetal Medicine Units and 4) propose a study for consideration by the Network<. We are enthusiastic about continuing to contribute to the success of the MFMU and to assure its continued pre-eminence in clinical research. PUBLIC HEATH RELEVANCE: The MFMU site at Magee has been a participant in all the prior Networks. We have contributed meaningfully to all of the prior Networks and hope to do so in the current Network.